The diagnosis of children cancer affects the family and continues to impact parental functioning after treatment ends. Our previous research showed the persistence of parents' distressing symptoms of posttraumatic stress and its association with anxiety. In this proposal, we focus on the identification of parental beliefs associated with anxiety and adaption during treatment for childhood cancer, and conduct a randomized clinical trial (RCT) of a cognitive-behavioral and family therapy intervention for parents of newly diagnosed children with cancer. The three session intervention, Surviving Cancer Competently Intervention Program, Revised (SCCIP-R) is an adaptation of our intervention protocol for survivors of childhood cancer and their families. The first step in the project is the systematic identification of mothers' and fathers' beliefs about the disease and the treatment in a sample of 120 families of children in families at diagnosis of childhood cancer, randomized to SCCIP-R intervention or an attention control condition. Baseline, 2 and 6 month data collections will include self-report measures of parental anxiety, psychological adjustment and family. Child quality of life will be assessed by parent and staff report. We will determine the affects of parental anxiety and its reduction on the child's quality of life. In a subsample of 62 patients with acute lymphoblastic (ALL), we will examine the associations of parental anxiety with parental neuroendocrine makers (DHEA-S/cortosol ratio, ACTH, Substance P) and explore the associations among lowered levels of parental levels of parental anxiety and medical outcomes. Finally, we will assess the long- term impact of SCCIP-R assessing parental and patient posttraumatic stress at two points after cancer treatment ends. To our knowledge, this project is unique in providing a RCT of an intervention to reduce parental distress after diagnosis of childhood cancer and in the integration of neuroendocrine makers and medical outcome. If effective, SCCIP-R would provide evidence for the feasibility and importance of providing systemic intervention with families of patients with cancer.